[Hemorrhages of the upper gastrointestinal tract. A comparison of the diagnostic accuracy between endoscopic and radiological examinations].
One hundred and forty-eight patients admitted for upper gastrointestinal hemorrhage, but excluding esophageal varices, underwent optic fibre gastroscopy at the time of admission and were then examined using a barium meal after a 24-48 h interval. The aim of the study was to compare the sensitivity, specificity and diagnostic accuracy of the two tests. A correct diagnosis was obtained using both procedures in 58.2% of cases. Endoscopy provided an accurate diagnosis in 35.1% of patients, whereas gastrointestinal x-rays showed the exact site of the lesion in only 6.7% of cases. Endoscopy had a sensitivity of 92.5% compared with 60.7% for the barium meal. Endoscopy also had a higher level of specificity (100%) versus the barium meal (33.3%). The results obtained from the pathological examination of specimens confirmed the accuracy of endoscopy. In conclusion, early endoscopy is a reliable procedure in the emergency assessment of the hemorrhaging patient; routine x-ray examination does not appear to add additional information and may be reserved for subsequent use if endoscopy gives doubtful or misleading indications of the site of bleeding.
Barbano
P R
PR
Divisione F. Ponti, Ospedale Niguarda Cà Granda, Miáno.
Coviello
D
D
Mariani
M
M
Rossi
M V
MV
Vecchi
M R
MR
D001466:Barium Sulfate; D004064:Digestive System / Q000000981:diagnostic imaging*; D016099:Endoscopy, Gastrointestinal; D005069:Evaluation Studies as Topic; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006396:Hematemesis / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008551:Melena / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D011859:Radiography
D001466:Barium Sulfate
Le emorragie del tubo gastroenterico superiore. Raffronto dell'accuratezza diagnostica fra esame endoscopico e radiologico.